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Artificial Organs

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https://www.readbyqxmd.com/read/29323413/extracorporeal-membrane-oxygenation-for-refractory-severe-respiratory-failure-in-acute-interstitial-pneumonia
#1
Gabriela Gonçalves-Venade, Nuno Lacerda-Príncipe, Roberto Roncon-Albuquerque, José Artur Paiva
Acute interstitial pneumonia (AIP) is a rare idiopathic interstitial lung disease with rapid progressive respiratory failure and high mortality. In the present report, three cases of AIP complicated by refractory respiratory failure supported with extracorporeal membrane oxygenation (ECMO) are presented. One male and two female patients (ages 27-59) were included. Venovenous ECMO support was provided using miniaturized systems, with two-site femoro-jugular circuit configuration. Despite lung protective ventilation, prone position and neuromuscular blockade, refractory respiratory failure of unknown etiology supervened (ratio of arterial oxygen partial pressure to fractional inspired oxygen 46-130) and ECMO was initiated after 3-7 days of mechanical ventilation...
January 11, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29323409/in-vitro-comparison-of-two-neonatal-ecmo-circuits-using-a-roller-or-centrifugal-pump-with-three-different-in-line-hemoconcentrators-for-maintaining-hemodynamic-energy-delivery-to-the-patient
#2
Madison Force, Morgan Moroi, Shigang Wang, David A Palanzo, Allen R Kunselman, Akif Ündar
The objective of this study was to compare three different hemoconcentrators (Hemocor HPH 400, Mini, and Junior) with two different neonatal ECMO circuits using a roller or a centrifugal pump at different pseudo-patient pressures and flow rates in terms of hemodynamic properties. This evidence-based research is necessary to optimize the ECMO circuitry for neonates. The circuits used a 300-mL soft-shell reservoir as a pseudo-patient approximating the blood volume of a 3 kg neonate, two blood pumps, and a Quadrox-iD Pediatric oxygenator with three different in-line hemoconcentrators (Hemocor HPH 400, Mini, and Junior)...
January 11, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29280162/managing-traps-and-pitfalls-during-initial-steps-of-an-ecmo-retrieval-program-using-a-miniaturized-portable-system-what-have-we-learned-from-the-first-two-years
#3
Anton Sabashnikov, Ilja Djordjevic, Antje-Christin Deppe, Elmar W Kuhn, Julia Merkle, Carolyn Weber, Dirk Sindhu, Kaveh Eghbalzadeh, Mohamed Zeriouh, Oliver J Liakopoulos, Parwis B Rahmanian, Ferdinand Kuhn-Régnier, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
The aim of this study was to provide early and mid-term results of the newly established extracorporeal membrane oxygenation (ECMO) retrieval service in a tertiary cardiothoracic center using the miniaturized portable Cardiohelp System (Maquet, Rastatt, Germany). A particular attention was paid to organizational and logistic specifics as well as challenges and pitfalls associated with initial phase of the program. From January 2015 until January 2017 a heterogenic group of 28 consecutive patients underwent ECMO implantation in distant hospitals for acute cardiac, pulmonary or combined failure as a bridge-to-decision and were subsequently transported to our institution...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29280161/modification-of-aortic-cannula-with-an-inlet-chamber-to-induce-spiral-flow-and-improve-outlet-flow
#4
Nofrizalidris Darlis, Kahar Osman, Muhamad Hasbullah Padzillah, Jeswant Dillon, Ahmad Zahran Md Khudzari
Physiologically, blood ejected from the left ventricle in systole exhibited spiral flow characteristics. This spiral flow has been proven to have several advantages such as lateral reduction of directed forces and thrombus formation, while it also appears to be clinically beneficial in suppressing neurological complications. In order to deliver spiral flow characteristics during cardiopulmonary bypass operation, several modifications have been made on an aortic cannula either at the internal or at the outflow tip; these modifications have proven to yield better hemodynamic performances compared to standard cannula...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29280157/native-bovine-and-porcine-pericardia-respond-to-load-with-additive-recruitment-of-collagen-fibers
#5
Andrea Bagno, Paola Aguiari, Michele Fiorese, Laura Iop, Michele Spina, Gino Gerosa
Bovine and porcine pericardia are currently used for manufacturing prosthetic heart valves: their design has become an increasingly important area of investigation in parallel with progressively expanding indications for the transcutaneous approach to heart valves replacement. Before being cut and shaped, pericardial tissues are expected to be properly characterized. Actually, the mechanical assessment of these biomaterials lacks standardized protocols. In particular, the role of preconditioning for achieving a constant mechanical response of tissue samples is still controversial...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29266315/recognition-of-a-virtual-maze-scene-using-simulated-prosthetic-vision
#6
Ying Zhao, Xiulin Geng, Qi Li, Guangqi Jiang, Yu Gu, Xiaoqi Lv
A real-time psychological physics experimental platform was built to aid in discovering the best real-time image processing strategy for the limited number of electrodes, and in providing the most useful prosthetic implant visual information. A number of maze pathfinder tasks were performed at low resolution to simulate use by blind individuals in performing daily visual activities. In this study, simple (5 rows × 5 columns), medium (8 × 8), and complex (11 × 11) maze models were created in 3DMAX. The models were constructed by using Unity to build virtual scenes for real-time pixel processing, including binarization, color inversion, and matching to templates with three different resolutions (16 × 16, 24 × 24, 32 × 32)...
December 21, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29266271/development-of-tissue-engineered-ligaments-elastin-promotes-regeneration-of-the-rabbit-medial-collateral-ligament
#7
Masaki Hirukawa, Shingo Katayama, Tatsuya Sato, Masayoshi Yamada, Satoshi Kageyama, Hironori Unno, Yoshiaki Suzuki, Yoshihiro Miura, Eri Shiratsuchi, Masahiro Hasegawa, Keiichi Miyamoto, Takashi Horiuchi
When ligaments are injured, reconstructive surgery is sometimes required to restore function. Methods of reconstructive surgery include transplantation of an artificial ligament and autotransplantation of a tendon. However, these methods have limitations related to the strength of the bone-ligament insertion and biocompatibility of the transplanted tissue after surgery. Therefore, it is necessary to develop new reconstruction methods and pursue the development of artificial ligaments. Elastin is a major component of elastic fibers and ligaments...
December 21, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29266311/neutrophil-gelatinase-associated-lipocalin-as-a-biomarker-of-allograft-function-after-renal-transplantation-evaluation-of-the-current-status-and-future-insights
#8
REVIEW
Maria Cappuccilli, Irene Capelli, Giorgia Comai, Giuseppe Cianciolo, Gaetano La Manna
Neutrophil gelatinase-associated lipocalin (NGAL), a protein belonging to the lipocalin superfamily initially found in activated neutrophils, is expressed by several cell types, including kidney tubule. The increase in NGAL production and release from tubular cells in response to various insults has been proven to predict acute kidney injury (AKI). For this reason, it has emerged as a valuable noninvasive biomarker of AKI in clinical nephrology. Also in the renal transplant setting, different studies have indicated NGAL as a valuable tool, especially in the early postoperative period, since the currently available clinical and laboratory parameters remain poorly sensitive to monitor immediate posttransplant graft function...
December 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29266279/donor-treatment-with-a-hypoxia-inducible-factor-1-agonist-prevents-donation-after-cardiac-death-liver-graft-injury-in-a-rat-isolated-perfusion-model
#9
Xingjian Zhang, Zhongzhong Liu, Qi Xiao, Cheng Zeng, Chin-Hui Lai, Xiaoli Fan, Qifa Ye, Yanfeng Wang, Yan Xiong
The protective role of hypoxia-inducible factor-1 (HIF-1) against liver ischemia-reperfusion injury has been well proved. However its role in liver donation and preservation from donation after cardiac death (DCD) is still unknown. The objective of this study was to test the hypothesis that pharmaceutical stabilization of HIF-1 in DCD donors would result in a better graft liver condition. Male SD rats (6 animals per group) were randomly given the synthetic prolyl hydroxylase domain inhibitor FG-4592 (Selleck, 6 mg/kg of body weight) or its vehicle (dimethylsulfoxide)...
December 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29266272/a-decrease-in-hypoxic-pulmonary-vasoconstriction-correlates-with-increased-inflammation-during-extended-normothermic-ex-vivo-lung-perfusion
#10
Sayed Himmat, Almothana Alzamil, Nader Aboelnazar, Sanaz Hatami, Christopher White, Peter Dromparis, Michael Mengel, Darren Freed, Jayan Nagendran
Normothermic ex vivo lung perfusion (EVLP) is an evolving technology to evaluate function of donor lungs to determine suitability for transplantation. We hypothesize that hypoxic pulmonary vasoconstriction (HPV) during EVLP will provide a more sensitive parameter of lung function to determine donor lung quality for lung transplantation. Eight porcine lungs were procured, and subsequently underwent EVLP with autologous blood and STEEN solution for 10 h. Standard physiologic parameters including dynamic compliance, peak airway pressure, and pulmonary vascular resistance (PVR) remained stable (P = 0...
December 20, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29235130/melt-electrospun-bilayered-scaffolds-for-tissue-integration-of-a-suture-less-inflow-cannula-for-rotary-blood-pumps
#11
Sam Liao, Christina Theodoropoulos, Keith A Blackwood, Maria A Woodruff, Shaun D Gregory
Implantation of left ventricular assist devices typically requires cardiopulmonary bypass support, which is associated with postoperative complications. A novel suture-less inflow cannula, which can be implanted without bypass, uses mild myocardial compression to seal the interface, however, this may lead to necrosis of the myocardium. To circumvent this issue, a bilayered scaffold has been developed to promote tissue growth at the interface between cannula and myocardium. The bilayered scaffold consists of a silicone base layer, which mimics the seal, and a melt electrospun polycaprolactone scaffold to serve as a tissue integration layer...
December 13, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29230826/evolution-of-biventricular-loading-condition-in-pediatric-lvad-patient-a-prospective-and-observational-study
#12
Arianna Di Molfetta, Roberta Iacobelli, Sergio Filippelli, Giorgia Grutter, Gianluigi Perri, Francesca Iodice, Luciano Pasquini, Paolo Guccione, Antonio Amodeo
The aim of this study was to describe the echocardiographic trend of left ventricular (LV) and right ventricular (RV) function after implantation of a pulsatile flow left ventricular assist device (LVAD) in children. From 2013 to 2016, we prospectively evaluated 13 consecutive pediatric Berlin Heart EXCOR LVAD patients. Clinical and echocardiographic data were collected at baseline, within 24 h after implantation and monthly until LVAD explant. Median age and weight at the implantation was 8 (4-23) months and 5 (4...
December 12, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29226358/mechanical-evaluation-of-tracheal-grafts-on-different-scales
#13
REVIEW
Fabio Gava Aoki, Henrique Takachi Moriya
Tissue engineered (or bioengineered) tracheas are alternative options under investigation when the resection with end-to-end anastomosis cannot be performed. One approach to develop bioengineered tracheas is a complex process that involves the use of decellularized tissue scaffolds, followed by recellularization in custom-made tracheal bioreactors. Tracheas withstand pressure variations and their biomechanics are of great importance so that they do not collapse during respiration, although there has been no preferred method of mechanical assay of tracheas among several laboratories over the years...
December 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29226341/inflammation-and-its-consequences-after-surgical-versus-transcatheter-aortic-valve-replacement
#14
Florian Uhle, Christian Castrup, Anna-Maria Necaev, Philippe Grieshaber, Christoph Lichtenstern, Markus Alexander Weigand, Andreas Böning
Symptomatic aortic stenosis can be treated by surgical aortic valve replacement (SAVR) or transcatheter aortic valve replacement (TAVR), the latter of which is regarded as a minimally invasive procedure. Differences between these procedures regarding immune responses or changes in coagulation and neurocognitive function have thus far been evaluated only sparsely. We carried out a prospective, single-center, nonrandomized explorative study with 38 patients. Thirteen patients were subjected to either SAVR or transfemoral (TF-) TAVR, and 12 patients underwent transapical (TA-) TAVR...
December 11, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29193160/multicenter-experience-with-mechanical-circulatory-support-using-a-new-diagonal-pump-in-233-children
#15
Brigitte Stiller, Robert Jan Houmes, André Rüffer, Matthias Kumpf, Andreas Müller, Florian Kipfmüller, Harald Köditz, Susanne Herber Jonat, Claudia Schmoor, Christoph Benk, Dick Tibboel, Thilo Fleck
Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of flows. We collected patient data from seven pediatric centers to conduct a retrospective cohort study. We examined 233 patients whose median age was 1.9 (0-201) months. The DP3 system was used for cardiopulmonary support as veno-arterial extracorporeal membrane oxygenation (ECMO) in 162 patients...
November 29, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29193165/precise-quantitative-assessment-of-the-clinical-performances-of-two-high-flux-polysulfone-hemodialyzers-in-hemodialysis-validation-of-a-blood-based-simple-kinetic-model-versus-direct-dialysis-quantification
#16
Paik-Seong Lim, Yuyu Lin, Minfeng Chen, Xiaoqi Xu, Yun Shi, Sudhir Bowry, Bernard Canaud
Highly permeable dialysis membranes with better design filters have contributed to improved solute removal and dialysis efficacy. However, solute membrane permeability needs to be well controlled to avoid increased loss of albumin that is considered to be detrimental for dialysis patients. A novel high-flux dialyzer type (FX CorDiax; Fresenius Medical Care) incorporating an advanced polysulfone membrane modified with nano-controlled spinning technology to enhance the elimination of a broader spectrum of uremic toxins has been released...
November 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29168199/experimental-investigation-of-left-ventricular-flow-patterns-after-percutaneous-edge-to-edge-mitral-valve-repair
#17
Morteza Jeyhani, Shahrokh Shahriari, Michel Labrosse
Mitral valve percutaneous edge-to-edge repair (PEtER) is a viable solution in high-risk patients with severe symptomatic mitral regurgitation. However, the generated double-orifice configuration poses challenges for the evaluation of the hemodynamic performance of the mitral valve and may alter flow patterns in the left ventricle (LV) during diastole. This in vitro study aims to evaluate the hemodynamic modifications following a simulated PEtER. A custom-made mitral valve was developed, and two configurations were tested: (i) a single-orifice valve with mitral regurgitation and (ii) a double-orifice mitral valve configuration following PEtER...
November 23, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29152759/retrieval-of-adult-patients-on-extracorporeal-membrane-oxygenation-by-an-intensive-care-physician-model
#18
Aidan J C Burrell, David V Pilcher, Vincent A Pellegrino, Stephen A Bernard
The optimal staffing model during the inter-hospital transfer of patients on extracorporeal membrane oxygenation (ECMO) is not known. We report the complications and outcomes of patients who were commenced on ECMO at a referring hospital by intensive care physicians and compare these findings with patients who had ECMO established at an ECMO center in Australia. This was a single center, retrospective observational study based on a prospectively collected ECMO database from Melbourne, Australia. Patients with severe cardiac and/or respiratory failure failing conventional supportive treatment between 2007-2013 were placed on ECMO via a physician-led model of ECMO retrieval, including two intensivists in a four person team, using percutaneous ECMO cannulation...
November 19, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29119570/timing-of-intra-aortic-balloon-pump-placement-before-off-pump-coronary-artery-bypass-grafting-and-clinical-outcomes
#19
Feng Liu, Feng Yang, Zhongtao Du, Na Miao, Yanyan Zhao, Bo Xu, Xiaotong Hou
We aimed to evaluate the timing of preoperative intra-aortic balloon pump (IABP) placement and outcomes in patients undergoing off-pump coronary artery bypass grafting (OPCAB). Patients with prophylactic IABP placement before OPCAB presenting between January 1, 2010 and December 31, 2013 were included. Patients were categorized into two groups based on the timing of preoperative IABP placement: less than 2 h (Group A, n = 223) and more than 2 h (Group B, n = 94). According to the European System for Cardiac Operative Risk Evaluation (EuroSCORE), patients were divided into two subgroups: middle-low EuroSCORE (<6, Groups A1 and B1) and high EuroSCORE (≥6, Groups A2 and B2)...
November 8, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29105103/development-of-a-pediatric-cardiac-mechanical-support-program
#20
Abhishek Kashyap, Joseph W Turek, Samantha J Wagner, Laura Felderman, Elizabeth A Jaggers, Peter J Gruber, R Erik Edens
The development of a pediatric cardiac support program is a complex, multidisciplinary project. This study describes the University of Iowa Congenital Heart Program's experience from its inception to the present. In, we examine those specific factors that have led to substantial improvements in the program, additionally identifying where further gains can be made. We retrospectively reviewed all pediatric patients who received mechanical cardiac support at the University of Iowa from the inception of the program in 1991...
November 3, 2017: Artificial Organs
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